There are many factors to consider when
deploying a new technology in imaging, especially one just approved by the
FDA. Breast tomosynthesis (approved
in February 2011) is an additional tool
that helps aid in breast cancer detection. It is a 3D mammography imaging
system that takes a series of low dose
x-rays reconstructed at one millimeter
intervals to reveal the inner architecture of the breast. Early studies suggest
this may improve cancer detection and
decrease the recall rate in a screening
population.

In preparation for adopting this
technology, it is important to speak to
key stakeholders. It is crucial to understand the audience that will need to be
educated about the technology. The best
program can be crippled if all parties are
not involved from the beginning. This
will identify barriers or gaps from the
time of inception and will allow for
operational changes to be created in
advance.

The radiologist needs to determine
how the technology will be implemented into the current interpretation workflow. There is a mandatory eight hour
online training for all interpreting physicians to comply with the MQSA, so this
needs to be built into the overall project

The benefit of having 3D breast imaging is that we cantake care of our patients on the first visit.

timeline. In addition, the radiologist is
the one who is responsible for creating
an algorithm for equipment use. We
chose to use the technology on patients
requiring diagnostic mammograms. It is
important to start out slowly, to allow for
radiologists to transition from interpreting four images to roughly 200 images.
Radiologists realize more time will need
to be dedicated towards interpretation;
however, the benefit outweighs the time.
As seen in Figure 1, in this particular occurrence cancer was not visible using 2D,
but once imaged using 3D it was visualized. One of the radiologists stated, “I
would have never found this cancer if I
was traditionally looking at 2D images.”
We have transitioned from using the
technology from the diagnostic setting
to now including the screening population as well.

Communication is vital when talkingabout new technology that will generateincreased radiation dose, roughly doublecompared to a traditional 2D screeningmammogram. It is essential to createtalking points that will be used by yourmammographers, physician relationsteam, marketing department, schedulingdepartment, and referring physicians.Most importantly, patients need to bereassured that we are patient advocates,and have their best interests in mind. Itis important that the dose is addressedup front and can be easily explained.The benefit of having 3D breast imagingis that we can take care of our patientson the first visit. The radiologist will haveincreased confidence to rule out cancerwithout recalling the patient for furtherimaging.